OBJECTIVE: Few studies have assessed the effect of erectile dysfunction (ED) treatment for psychological adjustment. This study assessed the impact of ED therapy on psychological functioning at baseline and 12-month follow-up using a battery of 10 standard psychological measures previously used in ED research. METHODS: Using an observational ED disease registry, clinical, sociodemographic psychological, and HRQoL information was collected at baseline prior to treatment and at 3, 6 and 12 months later. Psychological measures included the Beck Depression Inventory, a Life Satisfaction question, Marital Happiness item from the Locke Wallace Marital Adjustment Test, Mental Health Index 5, SF 36 Vitality scale, SOS 10 (a measure of general psychological health), State Trait Anxiety measure, and three MOS subscales (Positive Affect, Belonging/Loneliness, Marital Functioning). Only men who reported undergoing ED treatment were included in this analysis sub-sample. Patients were classified as treatment responders based on improvements in IIEF scores. Group means at baseline and 12-months and change between timepoints were compared using t-tests. RESULTS: The cohort consisted of 89 patients. 40 (45%) responded to therapy by the IIEF criteria. At one year, responders reported better psychological functioning on 7 measures, with differences being significant (p < .05) on Life Satisfaction, Marital Happiness, Positive Affect, and SOS 10. Responders reported significant improvement (p < .05) from baseline on 3 measures (Life Satisfaction, Positive Affect, and SOS 10) and a significant decline on one (SF 36 Vitality). CONCLUSIONS: Diagnosing and successfully treating ED has a significant impact on patient psychological functioning. These results should encourage providers to actively diagnose and treat ED. Data from this study show that men who fail primary therapy for ED should be offered secondary treatment, as many men in this study who failed prior therapies still reported improved psychological functioning when they began an effective secondary treatment.